Bringing treatment and other help to depressed, middle-aged
and older African Americans in their homes was modestly effective in a new
After four months of weekly one-hour sessions with a trained
social worker, participants scored lower on a scale measuring symptoms of
depression, compared to those who didn't get the home visits."Our focus
was very much to help people address their immediate concerns and anxieties and
become engaged in activities that are important to them," Laura Gitlin,
the study's lead author, told Reuters Health.
"For the treatment group compared to the control group they
benefited significantly more," Gitlin, who is director of the Center for
Innovative Care in Aging at Johns Hopkins University School of Nursing in
Beat the Blues
The programme, known as Beat the Blues, consists of regular
one-hour sessions in which participants are taught about depression, coping
methods and stress reduction techniques, and assessed to see if they have unmet
medical or social service needs.
The social workers helped participants with their external
problems – for instance, by linking them with social and medical services. They
also coached participants in identifying goals for activities that could help
improve their mood, such as making family meals, getting regular exercise,
travelling or taking classes, and helped participants create an action plan to
accomplish their goals.
Previous research has found that up to 30% of older African
Americans experience symptoms of depression. This same group is also at
increased risk of not receiving treatment, because they either lack access to
care or for cultural reasons they are not inclined to seek it, researchers
said. "Depression still remains a stigmatised form of disease that people
consider a natural part of ageing and something that you should overcome
yourself," Gitlin said.
"Working in the home is really destigmatising and
allows people to talk." For the new study, the researchers recruited 208
African Americans aged 55 and older to complete four months or 10 sessions of
Beat the Blues between 2008 and 2010. On a test that measures depressive
symptoms, all of the participants scored at least a 5 on a scale of 0 to 27,
with higher numbers representing more severe depression.
Researchers then randomly assigned half of the participants
to a group that received the treatments, while the other half was put on a
waiting list for the programme.
At the beginning of the study, people participating in the
sessions had an average depression score of 13.3, which represents moderately
severe depression. At the end, their average score fell to about 6.4.That
compared to the wait-listed group, which began the study with a severity score
of 12.7 and ended it with a score of 8.9.
"They showed some modest improvement in depressive
scores," Joel Sneed, an assistant professor in the Department of
Psychiatry at Columbia University in New York, told Reuters Health.
While the difference between the two groups may seem small,
the researchers write in the Annals of Internal Medicine that there were other
For example, 64% of programme participants showed improvements
at the end of their four months, compared to about 41% of waitlisted participants.
People who took part in the programme also maintained those
benefits after eight months. Sneed, who was not involved in the new study, said
it "shows something is better than nothing". "Something like
home-based interventions may be a treatment of choice for someone who is quite
sceptical about receiving help from the medical community," he added.
Gitlin said she thinks Beat the Blues can be used in
communities now because its components have been tested in other
studies. "I think it's ready for dissemination specifically for this group.
I also think it has great relevance for any disenfranchised group. That
includes Latinos and any low-income individuals," she said, adding that
they also have a study examining the programme's cost awaiting publication.